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Vol. VIII, No. 8 ~ EINet News Briefs ~ Apr 15, 2005
*****A free service of the APEC Emerging Infections Network*****
APEC EINet News Briefs offers the latest news, journal articles, and notifications for emerging infections affecting the APEC member economies. It was created to foster transparency, communication, and collaboration in emerging infectious diseases among health professionals, international business and commerce leaders, and policy makers in the Asia-Pacific region.
In this edition:
- International response to the distribution of a H2N2 influenza virus for laboratory testing: Risk considered low for laboratory workers and the public
- East Asia: Cumulative Number of Human Cases of Avian Influenza A/(H5N1)
- East Asia: FAO Latest information on Avian Influenza, summary report
- Indonesia, Thailand and Viet Nam: FAO “Focus on the issues”
- Viet Nam: 71 percent of ducks in southern Viet Nam infected with bird flu
- Viet Nam: Avian influenza WHO situation update
- Viet Nam: HIV Carrier Infected with Avian Influenza Virus
- North Korea: UN expert says N. Korean bird flu different from version in Southeast Asian
- North Korea: Requests help for Avian influenza from FAO/OIE
- North Korea: Requests Seoul's Help to Fight Bird Flu
- China: Explanation on Using Vaccines for the Prevention of Avian Influenza in China
- Cambodia: Avian influenza WHO situation update
- Indonesia: Avian Influenza Virus Identified in Pigs
- New Zealand: Disease strikes research scientist (Wellington)
- Russia: 5 humans develop trichinellosis in Buryatiya after consuming dog meat
- USA: Bush Authorizes Use of Quarantine Powers in Cases of Bird Flu
- Mexico: Report of low-pathogenic avian influenza
- USA/Canada: Strain of Clostridium difficile produces high levels of toxins A and B
- USA (Michigan): Drug-resistant staph infection spreading
- USA: Florida outbreak of E. coli is traced to 6 petting-zoo animals
- USA: Public Health officials report on tularemia outbreak at Boston University
- Canada: Ontario issues warning against unpasteurized milk
- Risk of oral infection with bovine spongiform encephalopathy agent in primates
- Outbreaks of Salmonella Infections Associated with Eating Roma Tomatoes—US and Canada, 2004
- Health Concerns Associated with Disaster Victim Identification After a Tsunami--Thailand, December 26, 2004--March 31, 2005
- Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food--10 Sites, US, 2004
- National Plan for Reliable Tuberculosis Laboratory Services Using a Systems Approach
- CDC International Course in Applied Epidemiology
- 50th Anniversary of the First Effective Polio Vaccine--April 12, 2005
- National Infant Immunization Week--April 24--30, 2005
- Web Portal to "One World, One Health: Building Interdisciplinary Bridges to Health in a Globalized World" Symposium
- Sixth International Symposium on the Epidemiology and Control of Foodborne Pathogens in Pork
- The Second Annual Biosafety and Biosecurity Training Course
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International response to the distribution of a H2N2 influenza virus for laboratory testing: Risk considered low for laboratory workers and the public
The Public Health Agency of Canada (PHAC) informed WHO 26 Mar 2005 that an influenza A/H2N2 virus was identified by the National Microbiology Laboratory in Winnipeg, Manitoba in Canada. The H2N2 virus identified was found to be similar to H2N2 viruses that circulated in humans in 1957-58 at the beginning of the so-called Asian influenza pandemic (the H2N2 strain killed 1 million to 4 million people worldwide in 1957 and 1958). The H2N2 virus which circulated at this time was fully transmissible among humans. It continued to circulate in humans and cause annual epidemics until 1968, when it vanished after the emergence of influenza A/H3N2 viruses that caused the next pandemic. Therefore, persons born after 1968 are expected to have no or only limited immunity to H2N2. H2N2 virus is not contained in current trivalent influenza vaccines.
Appropriate biosafety measures were immediately taken at the involved laboratory in Canada and respiratory surveillance measures initiated. Subsequent investigation by the Public Health Agency of Canada traced the source of the H2N2 virus to a panel of proficiency testing samples containing influenza A and influenza B viruses which the Canadian laboratory received from the College of American Pathologists (CAP) Feb 2005. CAP routinely sends various panels of proficiency testing samples to participating laboratories every year. Normally, currently circulating influenza A viruses (H3N2; H1N1) are used for proficiency testing. The H2N2 virus was distributed by CAP for the first time Oct 2004.
WHO, the US Department of Health and Human Services (HHS) and CDC were informed of the situation by PHAC 8 Apr 2005. The problem arose when Meridian Bioscience Inc. sent a panel of virus samples to about 3700 laboratories, some in doctors' offices, to be tested as part of routine quality-control certification conducted by the CAP. The 3700 samples were sent out beginning last fall. Neither the CAP nor Meridian was aware that the virus being shipped was the 1957 strain, said a spokesman for the college. The college asked the company to ship a type A strain of virus, and Meridian's paperwork indicated that this strain was benign. Subsequent investigation revealed that similar proficiency testing samples with H2N2 virus were sent to 3747 laboratories in 18 countries. 61 of these laboratories are located in 16 countries outside the USA and Canada. HHS has recently learnt that other proficiency testing providers have sent additional H2N2 containing samples to further laboratories in the USA.
On 8 Apr 2005, CAP asked all laboratories which participated in the proficiency testing to immediately destroy samples containing the H2N2 virus. On 12 Apr 2005, a second correspondence from CAP to these labs further requested that destruction of the H2N2 virus be confirmed and that any case of respiratory disease among laboratory workers be investigated and notified to national authorities. WHO has received the list of addresses of the involved laboratories and has provided detailed contact information to the relevant Ministries of Health and requested their collaboration.
As of 12 Apr 2005, there have been no reports of H2N2 infections in laboratory workers associated with the distribution of the H2N2 samples. The proper use of biological safety cabinets, along with the use of recommended personal protective equipment, greatly reduces the risk of laboratory-acquired influenza infections. While a few H2N2 laboratory acquired infections have been documented in the past, the likelihood of laboratory-acquired influenza infection is considered low when proper biosafety precautions are followed. The risk for the general population is also considered low. WHO recommends that biosafety procedures be reviewed for use on influenza viruses that have not circulated recently in humans and against which the majority of the population would have no protective immunity.
List of countries and areas that have received H2N2 influenza virus: Bermuda, Belgium, Brazil, Chile, France, Germany, Hong Kong, Israel, Italy, Japan, Lebanon, Mexico, The Republic of Korea, Saudi Arabia, Singapore, Taiwan, and China.
CDC also offers the latest information (http://www.cdc.gov/flu/h2n2situation.htm), with updated links to:
East Asia: Cumulative Number of Human Cases of Avian Influenza A/(H5N1)
The Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota compiles up-to-date figures of avian influenza cases and deaths in East Asia. As of 14 Apr 2005 the number of unofficial cases in East Asia from Jan 2004 to the present is 89 with 52 deaths; whereas the official WHO figures are 80 cases and 50 deaths. Numbers of cases reported mid-Dec 2004 to present are:
Economy / Unofficial (Official) Cases / Unofficial (Official) Deaths
East Asia: FAO Latest information on Avian Influenza, summary report
Viet Nam: Last known outbreak: 29 Mar - 4 Apr 2005. Total of 1300 ducks have either died or been culled in Tra Vinh Province. The confirmed human cases in Viet Nam reported by WHO have been 33 since 30 Dec 2004, of which 15 were fatal.
Thailand: Last known outbreak: 10-17 Mar 2005. Total of 50 birds have died or been culled in Ban Dan Lan Hoi district, Sukhothai Province.
Cambodia: Last known outbreak: 22-28 Mar 2005. Total of 139 chickens and ducks have been culled in Keatha Vong Leu village near Vietnamese border. A 28-year-old man who died 22 Mar 2005 and an 8-year-old girl who died 07 Apr 2005 both from Bantey Meas district, Kampot Province were confirmed to have been infected with H5N1.
Indonesia: During Jan - Mar 2005, HPAI had killed a total of 281 730 birds in Central Java, South Sulawesi and West Java Provinces. In Central Java Province, quail farms have been affected and over 77 000 poultry have either died or been culled. Inter-island chicken trade from South Sulawesi has been banned since mid Mar 2005. In West Java Province, 21 000 dead chickens were reported Jan - early Mar. HPAI had mostly affected quails in West Java. In Cirebon (declared as an epidemic area), destroyed quails were said to have been brought from Sleman (Yogyakarta). Some 200 000 doses of vaccine against H5N1 infection had been distributed to infected areas, and the government has set aside Rp 750 million (USD 79 000) and Rp 250 million [USD 26 000] backup fund to assist poultry breeders who destroyed their bird flu-infected flocks. Since 31 Mar 2005, West Java authorities have stopped all poultry traffic into the area. The poultry-check operation targeting chickens, quails and ducks was held in Losari.
Democratic People's Republic of Korea (DPRK): Outbreak of avian influenza was reported in 3 chicken farms including the Hadang Chicken Farm in Pyonyang province. The State Emergency Veterinary and Anti-Epizootic Committee has been organized and movement control, and increased surveillance in poultry farms has been implemented. A total of 219 000 poultry have been slaughtered. Increased mortalities were observed in Hadang Farm, and in 2 neighboring farms belonging to the same company. Veterinary authorities have vaccinated birds in these farms and the vicinity. A FAO expert is working with DPRK authorities in the diagnosis. Indirect evidence suggests that the strain is H7. (Promed 4/14/05; FAO http://www.fao.org/ag/againfo/home/en/home.html)
Indonesia, Thailand and Viet Nam: FAO “Focus on the issues”
Viet Nam: 71 percent of ducks in southern Viet Nam infected with bird flu
On 1 Apr 2005, Viet Nam started a month-long campaign to clean up poultry farms nationwide in a move to stamp out bird flu, which has hit 35 cities and provinces nationwide since Jan 2005. 33 localities have so far detected no new affected spots in their territory for 3 weeks, meeting the country's criteria to announce an end to the disease. To minimize the risk of infection, it has intensified publicity, urging local people not to eat dishes made from raw duck blood or to slaughter sick poultry for food and to avoid coming into contact with fowl without wearing protective gear. The role of ducks as reservoir of infection in Eastern Asia has been addressed during the recent FAO/OIE consultation, which concluded that the possibility of vaccinating ducks should be explored. Experimentally, vaccines have been shown to significantly reduce AI virus replication and shedding in domestic ducks and geese and thus decrease environmental contamination and prevent contact transmission. (Promed 4/13/05)
Viet Nam: Avian influenza WHO situation update
Viet Nam: HIV Carrier Infected with Avian Influenza Virus
North Korea: UN expert says N. Korean bird flu different from version in Southeast Asian
Poultry production is one of the few growing sectors in North Korea, which has relied on foreign aid to feed its people since it disclosed in the mid-1990s that its state farm system had collapsed. The number of the country's poultry was estimated at 25.5 million in 2004, about 2 times the level of 1997. According to a new definition of avian influenza in OIE's Terrestrial Animal Health Code, "Notifiable avian influenza" is an infection of poultry caused by any influenza A virus of the H5 or H7 subtypes or by any AI virus with an intravenous pathogenicity index (IVPI) greater than 1.2. (Promed 4/5/05)
North Korea: Requests help for Avian influenza from FAO/OIE
North Korea has asked FAO and OIE to provide diagnostic tools and technical assistance for disease control strategies, including vaccination. OIE and FAO welcomed North Korea's request as a sign of improved transparency and international cooperation. Both organisations said that they are ready to extend their technical support to ensure an effective control of the disease in the country. FAO experts have already been fielded to Pyonyang and are currently supporting the government in obtaining information on the extent of the outbreaks and designing control strategies. OIE has been asked to assist in the training of veterinary experts.
The FAO/OIE conference appealed to donor countries to provide more funds for the fight against avian influenza for which around USD 100 million would be urgently required. So far, only Germany, Japan and The Netherlands have expressed their willingness to financially support affected Asian countries. Many of the countries affected or threatened by AI are under-resourced and lack the capacity of veterinary services for an effective and early detection and response to the epidemic in poultry.
Improving the efficiency of veterinary services in affected countries is essential for controlling the disease at its source in poultry and free-farmed ducks. Strategies are needed for financing sustainable, concrete actions at local level. This is likely to include support for restocking or compensation for losses and should also encompass education on safe poultry keeping and development of appropriate infrastructures. Further scientific research is required to obtain more information on the potential virus transmission from animals to humans. The conference also urged laboratory networks coordinated by WHO, OIE/FAO to conduct research on H5N1 bird flu virus and other avian influenza viruses that could pose a potential threat to humans. Veterinary and Public Health Services should better work together to improve national, regional and global health security. Public Health Services should support the agriculture sector and veterinary services in order to control and eliminate the disease at its origin.
OIE and FAO announced the launch of the New Worldwide Avian Influenza Network (OFFLU) which will improve the collaboration between reference laboratories specialised on AI in animals, coordinated by OIE and FAO and laboratory networks focusing on human influenza coordinated by WHO. The network will speed up the immediate exchange of scientific data on bird flu and animal virus strains to produce efficacious vaccines for humans that respond to specific virus characteristics. (For more information on the OIE/FAO/WHO conference, see the FAO article at: http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/special_avian.html) (Promed 4/8/05)
North Korea: Requests Seoul's Help to Fight Bird Flu
China: Explanation on Using Vaccines for the Prevention of Avian Influenza in China
Based on the "National Emergency Plan Against High Pathogenic Avian Influenza" (HPAI), China has inoculated poultry flocks in areas susceptible to avian influenza infection. China has also inoculated poultry flocks on breeding farms, large-sized egg layer farms and in areas with a high concentration of water bodies. Poultry in certain areas designated "no enforced inoculation areas" or "no disease infected areas" have not been inoculated. Other areas apply voluntary inoculation. From Feb 2004 to Jan 2005, China has inoculated a total of 2.68 billion birds. The objective of China's poultry vaccine is to inactivate H5N1. During 2004, this vaccine played an important role in HPAI elimination and prevention in China. The vaccine is only manufactured at the plants designated by the Chinese Government.
The National Reference Laboratory has also developed 2 new vaccines. One is a recombinant AI H5N1 virus inactivated vaccine, and the other is a H5N1 fowl pox live virus vaccine. They are highly efficient, safe and can be produced cost-effectively. The recombinant H5N1 virus inactivated vaccine even works better against the HPAI because its protective period for chickens is longer, and it is especially effective for waterfowl immunity. The vaccine can efficiently stop the spread of the HPAI virus. Now, it is widely used for waterfowl inoculation in water concentrated areas in South China.
In order to strengthen disease control and guarantee inoculation quality, the MOA has carried out regular inoculation supervision and evaluation through sampling serum and pathogen tests among inoculated poultry flocks. Up to now, we have not isolated any H5N1 virus from our inoculated poultry flocks. At the same time, some provinces in South China have adopted a measure of placing inoculated poultry in highly exposed areas to watch the result of infection.
A. AI inactivated vaccine (H5 sub-type, N-28 strain)
2) Result: The antibody level reached the highest rate, 8 log2, during the 5th week after vaccination. This rate was maintained for 4 weeks. The antibody protective level can be sustained into the 23rd week after vaccination.
3) Feature: MOA approved this vaccine as a new bio-product for animal inoculation in Dec 2003. This vaccine was widely used in China during the outbreaks of HPAI at the beginning of 2004.
B. Recombinant AI virus inactivated vaccine (H5N1 sub-type, Re-1 strain)
2) Result: The antibody reached highest level of 9 log2 during the 3rd week after vaccination. This rate was maintained for 4 weeks. The antibody protective level can be sustained into the 25th week after vaccination.
3) Feature: MOA approved this vaccine as a new bio-product for animal inoculation in Jan 2005. It works efficiently for avian influenza, it helps poultry organs generate high levels of antibodies and the protective period lasts longer. The laboratory experiments proved that waterfowl inoculated with this vaccine are free of AI infection or infectivity. Many countries in the world now use this method to try to develop vaccines, but only China has succeeded and put the vaccine into commercial production.
C. Recombinant fowl pox virus live vaccine for AI (H5 sub-type)
2) Result: The antibody reached the highest level of 7 log2 during the 2nd week after vaccination. The antibody protective level can be sustained into the 26th week after vaccination.
3) Feature: MOA approved this vaccine as a new bio-product for animal inoculation in Jan 2005. It helps create antibodies against the antigen of specific proteins. It is good to differentiate immunity and field infection. Mexico also has this kind of vaccine and widely uses it.
During 2005, the Chinese Government will invest over RMB 5 billion (approximately USD 600 million) in animal disease control. (Promed 4/2/05)
Cambodia: Avian influenza WHO situation update
Human-to-human transmission as a source of the girl's infection appears unlikely, as none of her known contacts were sick with similar symptoms before she became ill. Investigations as to the source of the girl's infection are continuing. Samples were collected from 4 close contacts who cared for her at the village and 9 medical contacts from Kampot and Phnom Penh. All have tested negative for the H5N1 virus. The public education campaign in Banteay Meas and neighbouring districts is continuing. The recent funding from international donors will be crucial in helping Cambodia control this disease.
"We know she was in contact with chickens when they were dying in Feb 2005, but the exposure period is too long," WHO official Megge Miller said. "We're looking at the potential role of ducks as asymptomatic carriers," she said, noting that it was common for ducks not to show signs of the disease but still carry and spread the virus. Cambodia's first 2 victims, a woman aged 25 who died in January 2005 after traveling to Viet Nam for treatment in January 2005, and a 28-year-old man who died Mar 2005, were also from Kampot province, which borders Viet Nam. (Promed 4/12/05, 4/11/05)
Indonesia: Avian Influenza Virus Identified in Pigs
New Zealand: Disease strikes research scientist (Wellington)
ESR chief executive John Hay said the source of infection was unknown. Overseas expert Andrew Lawrence reviewed the lab's practices and reported that there were no recorded accidents. He had no reason to assume the disease was acquired in the lab. Mr Hay said the woman had worked with many strains of meningococcal disease before coming to work at the Kenepuru Science Centre. ESR has been researching a New Zealand strain of meningococcal bacterium for about 15 years. Medical officer of Health Annette Nesdale said that, the latest cases showed the meningococcal disease epidemic was far from over and demonstrated the importance of immunization. All 5 patients had been admitted to hospital; 3 had already been discharged and only the scientist remained in intensive care. Wellington Hospital infectious diseases specialist Tim Blackmore said the number of patients admitted with meningococcal disease in the past few weeks was unusual, but the disease was generally more common in winter. Health boards in the Wellington region are preparing to immunize more than 100 000 babies, children and teenagers starting May 2005. It is not stated what serotypes were involved; nor is it stated whether the researcher had previously received meningococcal vaccination. (Promed 4/7/05)
Russia: 5 humans develop trichinellosis in Buryatiya after consuming dog meat
USA: Bush Authorizes Use of Quarantine Powers in Cases of Bird Flu
President Bush signed an executive order authorizing the government to impose a quarantine to deal with any outbreak of the particularly lethal bird flu. The fatality rate among those reported to have contracted the disease is about 70 percent. Health officials around the world are trying to monitor the virus because some flu pandemics are thought to have begun with birds. Mr. Bush's order added pandemic influenza to the government's list of communicable diseases for which a quarantine is authorized. It gives the government authority to detain or isolate a passenger arriving in the United States to prevent an infection from spreading. The authority would be used only if the passenger posed a threat to public health and refused to cooperate with a voluntary request, the Department of Health and Human Services said. The quarantine list was amended in 2003 to include SARS, or severe acute respiratory syndrome, which killed nearly 800 people in 2003. Other diseases on the list are cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever and viral hemorrhagic fevers.
Quarantine and isolation were last used during the SARS outbreak in 2003. The last large-scale quarantine was during the Spanish flu pandemic of 1918-19, though there have been lesser quarantines -- for instance, travelers coming off airliners or cruise ships who have been exposed to curable diseases. Jennifer Morcone, a spokeswoman for the health centers, said Mr. Bush's executive order was intended to prepare for all options. The Public Health Service, Ms. Morcone said, would typically recommend voluntary home quarantine when possible. In general, the government defers to state and local authorities in their use of quarantine powers and would work with them in case of an outbreak, she said. (Promed 4/2/05)
Mexico: Report of low-pathogenic avian influenza
USA/Canada: Strain of Clostridium difficile produces high levels of toxins A and B
According to an SHEA news release, the toxic strain is identical to that which caused outbreaks in 7 hospitals across 6 US states, 2001 to 2004. Data presented in 2004 at the Infectious Diseases Society of America meeting suggest that the bacterium is resistant to fluoroquinolone therapy. The study was initiated to identify the emergent strain related to the quadrupled incidence of C. difficile-associated diarrhea and almost doubled case-fatality ratio observed at CHUS during 1991 to 2003, as reported in an earlier study by Jacques Pepin, MD. "The perception of a number of physicians is that the strain they are dealing with is more virulent than usual," Michel Warny, MD, PhD, lead investigator and director of bacterial process development for Acambis Inc, told Medscape. "This is illustrated by the substantial increase in mortality per case of C. difficile infection since the year 2000."
In the study, a single identical strain (toxinotype III) was identified in 82 percent of isolates collected from patients involved in the CHUS outbreak. Dr. Warny noted, "This finding was significant because in general the toxinotype III strain is found in only 2 percent of isolates." Further, the toxinotype III strain was found to produce 16 times more toxin A and 20 times more toxin B in vitro compared with 13 variations of the toxinotype 0 strain commonly found in 80 percent of isolates. "The main pathogenic factor of C. difficile is the production of these 2 toxins," said Dr. Warny, suggesting that the ability of the emerging strain to produce up to 20 times more toxin than more common strains may explain reports of its virulence. (Promed 4/12/05)
USA (Michigan): Drug-resistant staph infection spreading
MRSA is a skin and soft tissue infection. It is also found in some pneumonias, said Dr. Lilly Immergluck, an infectious disease specialist at DeVos Children's Hospital. It has also turned up on athletic teams, among Marine recruits, and in hospitals and nursing homes. The MRSA infection has 2 epidemiological strains: 1 picked up in hospitals and the other in the community. In hospitals, it is most likely to strike those already in a weakened state. It is suspected of causing 2 million infections and 88 000 deaths worldwide each year. The community-acquired infection is appearing in healthy people as well as those with weakened immune systems, Immergluck said. Doctors and hospitals aren't required to report single cases of MRSA, so it's impossible to get accurate figures about prevalence, said T.J. Bucholz, a spokesman for the Michigan Department of Community Health. However, health officials do report outbreaks or clusters of cases. "We know anecdotally, though, that we are hearing of more cases now," Bucholz said. Community-associated (CA) MRSA has become a common and serious problem.
***In the 7 Apr 2005 issue of the New England Journal of Medicine, there are 2 full-length publications, 2 letters, and an editorial regarding CA MRSA. (Promed 4/12/05)
USA: Florida outbreak of E. coli is traced to 6 petting-zoo animals
Agventure was the only zoo to provide animals to the 3 fairs that have been identified as sources of human contact with E. coli. Dr. John O. Agwunobi, Florida's secretary of health, said 8 Apr 2005 that the 6 animals at issue were the only ones identified -- through DNA testing on them and patients -- as carrying the bacteria. State officials said the infected animals -- 2 sheep, 2 calves and 2 goats -- would be permanently barred from contact with the public and from slaughter for human consumption. The problem is that even healthy, well-kept animals can harbor intestinal diseases and parasites harmful to humans. Transmission can occur when animals step or sit in their own feces and then are petted or fed by children, who then put their hands in their mouths. Simple hand-washing is key to preventing transmission of these bacteria and parasites. (Promed 4/8/05, 4/4/05)
USA: Public Health officials report on tularemia outbreak at Boston University
1. At this time, the source of Type A F. tularensis in the BU laboratory remains unknown. The federal investigation into the incident is pending.
2. The extensive investigation to date has found no evidence to indicate that either the contamination of the LVS stock or the infections of the BU researchers were intentional.
3. The tularemia outbreak at BU was limited to 3 BU employees and never posed a risk to the public at large.
4. The failure to identify work-related illness in laboratory staff is a major concern for health officials.
5. The failure to immediately report suspicious work-related illness to local and state health departments is a major concern.
6. Appropriate infection control practices in laboratories must be clearly documented for all workers and enforced.
7. The BU Institutional Biosafety Committee was not able to ensure compliance with appropriate laboratory protocols and procedures.
The full report can be found at: http://www.bphc.org/reports/pdfs/report_202.pdf (Promed 4/13/05)
Canada: Ontario issues warning against unpasteurized milk
E. coli O157:H7 is just one of a number of infections that can be transmitted to humans from unpasteurized milk or dairy products. These include Salmonella sp and Campylobacter sp, both of which may be multi-drug resistant, as well as staphylococcal food poisoning, Q fever, listeriosis, brucellosis as well as bovine tuberculosis. Additionally, Brainerd diarrhea, a chronic diarrheal process of unknown etiology is also associated with raw milk ingestion. Symptoms of E. coli O157 include severe stomach cramps and diarrhea (sometimes bloody). Young children and seniors are also at higher risk of developing serious complications, which can be fatal. Dr. Basrur is also asking the public to report sales of unpasteurized milk to the Ministry of Agriculture and Food's complaint line: 1-888-466-2372 ext. 64391. The Ministry of Health and Long-Term Care continues to monitor the situation. (Promed 4/11/05)
Seasonal influenza activity for the Asia Pacific and APEC Economies 2005, 7 Apr 2005
Overall influenza activity declined in week 12, 2005. Influenza activity declined in most parts of the world in week 12 except in Hong Kong. Overall levels of influenza activity were medium–low. While the total number of influenza viruses detected decreased significantly, the proportion of B viruses increased.
Canada. Overall influenza activity continued to decline, with widespread activity reported in 2 provinces. Of the influenza viruses detected during week 12, 42% were influenza A and 58% were B viruses.
Hong Kong. The number of influenza viruses isolated increased significantly in weeks 11–12, although overall influenza activity remained medium–low. Influenza A(H3N2) and B viruses co-circulated.
Japan. Influenza activity continued to decline and was reported as sporadic in week 12.
Russia. A decrease in influenza activity was observed in week 12, although widespread activity remained.
USA. Influenza activity continued to decline in weeks 11–12. The overall ILI consultation rate was still above the national baseline, although it has declined during the past 5 weeks. The proportion of deaths attributable to pneumonia and influenza remained above the epidemic threshold. During weeks 10–11, 6 additional influenza-associated pediatric deaths were reported. Of the influenza viruses detected in week 12, 37% were influenza A viruses and 63% were B viruses.
Other reports. During weeks 11–12, Brazil, Chile, Malaysia and Mexico reported no influenza activity. (WHO 4/7/05 http://www.who.int/csr/disease/influenza/update/en/print.html)
USA, from CDC Weekly Report: Influenza Summary Update, Week ending April 9, 2005-Week 14
An MMWR summary of influenza activity in the US during Oct 3, 2004--Mar 26, 2005 is available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5413a2.htm.
Addendum to the recommended composition of influenza virus vaccines for 2005-2006 season
Risk of oral infection with bovine spongiform encephalopathy agent in primates
Lasmezas CI et al.
”The uncertain extent of human exposure to bovine spongiform encephalopathy (BSE)--which can lead to variant Creutzfeldt-Jakob disease (vCJD)--is compounded by incomplete knowledge about the efficiency of oral infection and the magnitude of any bovine-to-human biological barrier to transmission. We therefore investigated oral transmission of BSE to non-human primates. We gave two macaques a 5 g oral dose of brain homogenate from a BSE-infected cow. One macaque developed vCJD-like neurological disease 60 months after exposure, whereas the other remained free of disease at 76 months. On the basis of these findings and data from other studies, we made a preliminary estimate of the food exposure risk for man, which provides additional assurance that existing public health measures can prevent transmission of BSE to man…” (Promed 4/5/05, Lancet. 2005 Feb 26;365(9461):730-1.)
Outbreaks of Salmonella Infections Associated with Eating Roma Tomatoes—US and Canada, 2004
Health Concerns Associated with Disaster Victim Identification After a Tsunami--Thailand, December 26, 2004--March 31, 2005
Preliminary FoodNet Data on the Incidence of Infection with Pathogens Transmitted Commonly Through Food--10 Sites, US, 2004
National Plan for Reliable Tuberculosis Laboratory Services Using a Systems Approach
Recommendations from CDC and the Association of Public Health Laboratories Task Force on Tuberculosis Laboratory Services
To eliminate TB in the United States, improvements are needed in laboratory services to support treatment, prevention, and control. Developing an integrated system that ensures prompt and reliable laboratory testing and flow of information among laboratorians, clinicians, and TB-control officials is critical. For the full article, visit: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5406a1.htm (CDC MMWR Recommendations and Reports, April 15, 2005 / Vol. 54 / No. RR–6)
CDC International Course in Applied Epidemiology
Computer training using Epi Info, a software program developed at CDC and the WHO for epidemiologists, is included. Prerequisites include familiarity with the vocabulary and principles of basic epidemiology or completion of CDC's "Principles of Epidemiology" home-study course or equivalent. Early registration deadline is Jun 1; late registration deadline is Sep 1. Additional information is available from Emory University's Rollins School of Public Health, International Health Dept. (Attn: Pia), 1518 Clifton Road, N.E., Room 746, Atlanta, GA 30322; fax, 404-727-4590; at http://www.sph.emory.edu/epicourses; or by email, pvaleri@ sph.emory.edu. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5413a6.htm (MMWR April 8, 2005 / 54(13);336)
50th Anniversary of the First Effective Polio Vaccine--April 12, 2005
Through support by the National Foundation for Infantile Paralysis (the March of Dimes), Thomas Francis Jr. of the University of Michigan led the pioneering field studies of inactivated polio vaccine that led to the April 12, 1955, announcement. Approximately 1.8 million children from 217 areas of the United States, Canada, and Finland participated in the vaccine field studies. Thousands of health-care workers and lay persons volunteered to assist with the field studies, the largest ever in U.S. history. The National Foundation for Infantile Paralysis also supported the development work of Albert Sabin, whose oral polio vaccine (OPV) was licensed in 1961. The Global Polio Eradication Initiative, spearheaded by the WHO, Rotary International, UNICEF, and CDC, was begun in 1988. That year, an estimated 350,000 children were stricken with polio worldwide; in 2004, polio cases had decreased to approximately 1,200 cases globally. Although the Americas are polio-free, the disease still exists in some countries in Asia and Africa. Using the Sabin OPV, the Initiative continues to conduct immunization campaigns in those countries that have not been declared polio-free.
Information about polio disease, vaccine, and eradication efforts is available at http://www.cdc.gov/nip.
National Infant Immunization Week--April 24--30, 2005
During NIIW, states and hundreds of communities throughout the US will sponsor activities highlighting the need to achieve and maintain high childhood vaccination coverage rates. Special kick-off events, including provider education activities, media events, and immunization clinics are planned along the US--Mexico border in collaboration with state and local health departments, the US--Mexico Border Health Commission, and PAHO. In addition, CDC and its partners will introduce a new public education campaign. NIIW is being held in conjunction with Vaccination Week in the Americas, scheduled for April 23--30. That event, sponsored by PAHO, promotes childhood immunization and access to health services concurrently in all countries in the Western Hemisphere. Additional information about NIIW and childhood vaccination is available from CDC's National Immunization Program at http://www.cdc.gov/nip. Information on Vaccination Week in the Americas is available at http://www.paho.org/english/dd/pin/pr050211.htm.
Web Portal to "One World, One Health: Building Interdisciplinary Bridges to Health in a Globalized World" Symposium
Sixth International Symposium on the Epidemiology and Control of Foodborne Pathogens in Pork
The Second Annual Biosafety and Biosecurity Training Course
- 8-10 Jul 2005: animal oriented (one day on large animal ABSL-2 and -3 facilities, containment, etc; one day on small animal ABSL-2 and -3 facilities and containment; 1/2 day on veterinary hospital, clinic, and farm and ranch Biosecurity (infection control)).
- 11-12 Jul 2005: general Biosafety and Biosecurity (BMBL, rDNA Guidelines, Biosafety committees, other administration aspects, risk assessment, Select Agent regulations and administration, HEPA filters and biosafety cabinet certification).
- 12-14 Jul 2005: plant oriented (containment of recombinant plants, infectious disease research with plants, biopharm, regulations, permits, plant disease diagnostic lab network, diseases of crops, and greenhouse design and management).
For more information: <http://www.cvmbs.colostate.edu/microbiology/crwad/relatedmeetings.htm> Contact: Robert Ellis, 970-491-6729, firstname.lastname@example.org (Promed 4/13/05)
4. APEC EINet activities
New subscription system through APEC EINet website
The APEC EINet website now allows for automatic subscription at: http://depts.washington.edu/einet/?a=subscribe. Additional recent features include: 1) A Search and Browse function which allows you to look for specific information from the EINet Newsbriefs and Alerts (currently only available for data from 2005 and Dec 2004 Tsunami Alerts) 2) Print option which allows you to print the specific article you are interested 3) Email option which allows you to email an article.
5. To Receive EINet Newsbriefs
APEC EINet email list
The APEC EINet email list was established to enhance collaboration among academicians and public health professionals in the area of emerging infections surveillance and control. Subscribers are encouraged to share their material with colleagues in the Asia-Pacific Rim. To subscribe (or unsubscribe), go to: http://depts.washington.edu/einet/?a=subscribe or contact email@example.com. Further information about the APEC Emerging Infections Network is available at http://depts.washington.edu/einet/.